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Elevated Titanium Levels After Revision Total Hip Caused by Previously Unreported Mechanism
Brian G Josephson1, Timothy A Damron
1From the Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY.
Summary
Elevated titanium levels after total hip arthroplasty are rare and typically linked to trunnionosis. This study identifies a novel cause: friction between cables and the titanium implant, leading to titanium metallosis.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Toxicology
Background:
- Metallosis following total hip arthroplasty (THA) is a known complication.
- It is commonly associated with elevated serum cobalt and chromium levels, often due to trunnionosis.
- Elevated serum titanium levels are infrequently reported in THA patients.
Observation:
- This report details two unique cases of THA patients presenting with significantly elevated serum titanium levels.
- These cases share a previously undocumented mechanism contributing to metallosis.
Findings:
- The source of elevated titanium was identified as fretting corrosion resulting from the contact between surgical cables and the titanium implant stem.
- This represents a new mechanism for titanium metallosis in the context of THA.
Implications:
- This finding expands the understanding of potential causes for metallosis after total hip arthroplasty.
- It highlights the importance of considering implant-cable interactions as a source of metal ion release.
- Clinicians should be aware of this novel mechanism when evaluating patients with unexplained elevated titanium levels post-THA.
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